{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T02:25:25Z","timestamp":1786328725552,"version":"build-2736575974"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"16","license":[{"start":{"date-parts":[[2022,9,5]],"date-time":"2022-09-05T00:00:00Z","timestamp":1662336000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,11,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Cardiac sequelae after COVID-19 have been described in athletes, prompting the need to establish a return-to-play (RTP) protocol to guarantee a safe return to sports practice. Sports participation is strongly associated with multiple short- and long-term health benefits in children and adolescents and plays a crucial role in counteracting the psychological and physical effects of the current pandemic. Therefore, RTP protocols should be balanced to promote safe sports practice, particularly after an asymptomatic SARS-CoV-2 infection that represents the common manifestation in children. The present consensus document aims to summarize the current evidence on the cardiac sequelae of COVID-19 in children and young athletes, providing key messages for conducting the RTP protocol in paediatric athletes to promote a safe sports practice during the COVID-19 era.<\/jats:p>","DOI":"10.1093\/eurjpc\/zwac180","type":"journal-article","created":{"date-parts":[[2022,8,24]],"date-time":"2022-08-24T11:47:13Z","timestamp":1661341633000},"page":"2120-2124","source":"Crossref","is-referenced-by-count":11,"title":["Cardiac screening prior to return to play after SARS-CoV-2 infection: focus on the child and adolescent athlete:\n                    <i>A Clinical Consensus Statement of the Task Force for Childhood Health of the European Association of Preventive Cardiology<\/i>"],"prefix":"10.1093","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0947-6836","authenticated-orcid":false,"given":"Flavio","family":"D\u2019Ascenzi","sequence":"first","affiliation":[{"name":"Department of Medical Biotechnologies, Division of Cardiology, University of Siena , V.le M. Bracci, 16 53100, Siena ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9693-4083","authenticated-orcid":false,"given":"Silvia","family":"Castelletti","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Auxologico Italiano, Cardiomyopathy Unit and Department of Cardiovascular, Neural and Metabolic Sciences , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo Emilio","family":"Adami","sequence":"additional","affiliation":[{"name":"Health and Science Department, World Athletics , Monaco ,","place":["Principality of Monaco"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0221-6000","authenticated-orcid":false,"given":"Elena","family":"Cavarretta","sequence":"additional","affiliation":[{"name":"Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome , Latina ,","place":["Italy"]},{"name":"Mediterranea Cardiocentro , Naples ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Sanz-de la Garza","sequence":"additional","affiliation":[{"name":"Cardiovascular Institute, Hospital Cl\u00ednic, IDIBAPS, University of Barcelona , Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3225-8378","authenticated-orcid":false,"given":"Viviana","family":"Maestrini","sequence":"additional","affiliation":[{"name":"Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Biffi","sequence":"additional","affiliation":[{"name":"Med-Ex, Medicine and Exercise srl, Medical Partner Scuderia Ferrari , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Kantor","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Pediatrics, Children\u2019s Hospital of Los Angeles, Keck School of Medicine, University of Southern California , Los Angeles, CA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guido","family":"Pieles","sequence":"additional","affiliation":[{"name":"Sports Medicine Department, Aspetar, Orthopaedic and Sports Medicine Hospital , Doh ,","place":["Qatar"]},{"name":"Institute of Sport Exercise and Health (ISEH), University College London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evert","family":"Verhagen","sequence":"additional","affiliation":[{"name":"Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, University Medical Centers - Vrije Universiteit Amsterdam , Amsterdam ,","place":["Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Tiberi","sequence":"additional","affiliation":[{"name":"Sport Medicine, Department of Prevention , ASUR Marche Area Vasta 1, Pesaro ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5501-4205","authenticated-orcid":false,"given":"Henner","family":"Hanssen","sequence":"additional","affiliation":[{"name":"Department of Sport, Exercise and Health, Medical Faculty, University of Basel , Basel ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Papadakis","sequence":"additional","affiliation":[{"name":"Cardiovascular Clinical Academic Group, St George\u2019s, University of London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josef","family":"Niebauer","sequence":"additional","affiliation":[{"name":"University Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University of Salzburg , Salzburg ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3065-530X","authenticated-orcid":false,"given":"Martin","family":"Halle","sequence":"additional","affiliation":[{"name":"Department of Prevention and Sports Medicine, Accredited Centre for Sports Cardiology\/EAPC, School of Medicine, University Hospital Klinikum rechts der Isar, Technical University of Munich , Georg-Brauchle-Ring 56, D-80992 Munich ,","place":["Germany"]},{"name":"DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance , Potsdamer Str. 58, 10785 Berlin ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,9,5]]},"reference":[{"key":"2026080911292617600_zwac180-B1","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1161\/CIRCULATIONAHA.120.049836","article-title":"Review of cardiac involvement in multisystem inflammatory syndrome in children","volume":"143","author":"Alsaied","year":"2021","journal-title":"Circulation"},{"key":"2026080911292617600_zwac180-B2","first-page":"e7485","article-title":"Coronavirus disease (COVID-19) and pediatric patients: a review of epidemiology, symptomatology, laboratory and imaging results to guide the development of a management algorithm","volume":"12","author":"Hasan","year":"2020","journal-title":"Cureus"},{"key":"2026080911292617600_zwac180-B3","doi-asserted-by":"crossref","first-page":"1859","DOI":"10.1093\/eurheartj\/ehaa288","article-title":"COVID-19-related myocarditis in a 21-year-old female patient","volume":"41","author":"Kim","year":"2020","journal-title":"Eur Heart J"},{"key":"2026080911292617600_zwac180-B4","doi-asserted-by":"crossref","first-page":"e204","DOI":"10.1097\/INF.0000000000002788","article-title":"COVID-19-associated myocarditis in an adolescent","volume":"39","author":"Trogen","year":"2020","journal-title":"Pediatr Infect Dis J"},{"key":"2026080911292617600_zwac180-B5","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1016\/j.ijcard.2021.05.042","article-title":"A prospective study on the consequences of SARS-CoV-2 infection on the heart of young adult competitive athletes: implications for a safe return-to-play","volume":"336","author":"Cavigli","year":"2021","journal-title":"Int J Cardiol"},{"key":"2026080911292617600_zwac180-B6","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1001\/jamacardio.2021.2079","article-title":"Return to play for athletes after COVID-19 infection: the fog begins to clear","volume":"6","author":"Udelson","year":"2021","journal-title":"JAMA Cardiol"},{"key":"2026080911292617600_zwac180-B7","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1001\/jamacardio.2020.7444","article-title":"Evaluation for myocarditis in competitive student athletes recovering from coronavirus disease 2019 with cardiac magnetic resonance imaging","volume":"6","author":"Starekova","year":"2021","journal-title":"JAMA Cardiol"},{"key":"2026080911292617600_zwac180-B8","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1161\/CIRCULATIONAHA.120.048360","article-title":"Acute heart failure in multisystem inflammatory syndrome in children in the context of global SARS-CoV-2 pandemic","volume":"142","author":"Belhadjer","year":"2020","journal-title":"Circulation"},{"key":"2026080911292617600_zwac180-B9","doi-asserted-by":"crossref","first-page":"1242","DOI":"10.1177\/2047487320930596","article-title":"Exercise in the severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2) era: a question and answer session with the experts endorsed by the section of sports cardiology & exercise of the European Association of Preventive Cardiology (EAPC)","volume":"27","author":"Bhatia","year":"2020","journal-title":"Eur J Prev Cardiol"},{"key":"2026080911292617600_zwac180-B10","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1136\/bjsports-2020-102710","article-title":"Cardiorespiratory considerations for return-to-play in elite athletes after COVID-19 infection: a practical guide for sport and exercise medicine physicians","volume":"54","author":"Wilson","year":"2020","journal-title":"Br J Sports Med"},{"key":"2026080911292617600_zwac180-B11","doi-asserted-by":"crossref","first-page":"e20200702","DOI":"10.1542\/peds.2020-0702","article-title":"Epidemiology of COVID-19 Among Children in China","volume":"145","author":"Dong","year":"2020","journal-title":"Pediatrics"},{"key":"2026080911292617600_zwac180-B12","doi-asserted-by":"crossref","first-page":"1663","DOI":"10.1056\/NEJMc2005073","article-title":"SARS-CoV-2 infection in children","volume":"382","author":"Lu","year":"2020","journal-title":"N Engl J Med"},{"key":"2026080911292617600_zwac180-B13","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2020-009399","article-title":"COVID-19 disease severity risk factors for pediatric patients in Italy","volume":"146","author":"Bellino","year":"2020","journal-title":"Pediatrics"},{"key":"2026080911292617600_zwac180-B14","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.1002\/jmv.26398","article-title":"A systematic review and meta-analysis of children with coronavirus disease 2019 (COVID-19)","volume":"93","author":"Cui","year":"2021","journal-title":"J Med Virol"},{"key":"2026080911292617600_zwac180-B15","doi-asserted-by":"crossref","first-page":"101825","DOI":"10.1016\/j.tmaid.2020.101825","article-title":"Comorbidities, clinical signs and symptoms, laboratory findings, imaging features, treatment strategies, and outcomes in adult and pediatric patients with COVID-19: a systematic review and meta-analysis","volume":"37","author":"Jutzeler","year":"2020","journal-title":"Travel Med Infect Dis"},{"key":"2026080911292617600_zwac180-B16","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1136\/bjsports-2021-104764","article-title":"SARS-CoV-2 infection and return to play in junior competitive athletes: is systematic cardiac screening needed?","volume":"56","author":"Cavigli","year":"2022","journal-title":"Br J Sports Med"},{"key":"2026080911292617600_zwac180-B17","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1136\/bjsports-2020-102789","article-title":"Is extensive cardiopulmonary screening useful in athletes with previous asymptomatic or mild SARS-CoV-2 infection","volume":"55","author":"Gervasi","year":"2021","journal-title":"Br J Sports Med"},{"key":"2026080911292617600_zwac180-B18","doi-asserted-by":"crossref","first-page":"616622","DOI":"10.3389\/fped.2020.616622","article-title":"COVID-19 pneumonia in children: from etiology to management","volume":"8","author":"Parisi","year":"2020","journal-title":"Front Pediatr"},{"key":"2026080911292617600_zwac180-B19","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1056\/NEJMoa2021756","article-title":"Multisystem inflammatory syndrome in children in New York state","volume":"383","author":"Dufort","year":"2020","journal-title":"N Engl J Med"},{"key":"2026080911292617600_zwac180-B20","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1001\/jamapediatrics.2020.5052","article-title":"Assessment of 135794 pediatric patients tested for severe acute respiratory syndrome Coronavirus 2 across the United States","volume":"175","author":"Bailey","year":"2021","journal-title":"JAMA Pediatr"},{"key":"2026080911292617600_zwac180-B21","doi-asserted-by":"crossref","first-page":"1597","DOI":"10.1007\/s00431-021-04345-z","article-title":"Long COVID symptoms and duration in SARS-CoV-2 positive children - a nationwide cohort study","volume":"181","author":"Borch","year":"2022","journal-title":"Eur J Pediatr"},{"key":"2026080911292617600_zwac180-B22","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1016\/S0140-6736(19)32540-1","article-title":"A future for the world\u2019s children? A WHO-UNICEF-Lancet Commission","volume":"395","author":"Clark","year":"2020","journal-title":"Lancet"},{"key":"2026080911292617600_zwac180-B23","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.1136\/bjsports-2020-102955","article-title":"World Health Organization 2020 guidelines on physical activity and sedentary behaviour","volume":"54","author":"Bull","year":"2020","journal-title":"Br J Sports Med"},{"key":"2026080911292617600_zwac180-B24","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1177\/1559827618754842","article-title":"Promoting physical activity through youth sports programs: it\u2019s social","volume":"14","author":"Howie","year":"2020","journal-title":"Am J Lifestyle Med"},{"key":"2026080911292617600_zwac180-B25","doi-asserted-by":"publisher","DOI":"10.23736\/S0031-0808.21.04340-8","article-title":"Cardiovascular effects of COVID-19 lockdown in professional Football players","author":"Cavarretta","year":"2021","journal-title":"Panminerva Med"},{"key":"2026080911292617600_zwac180-B26","doi-asserted-by":"crossref","first-page":"3229","DOI":"10.1016\/j.jacc.2021.04.071","article-title":"Adolescent body mass index and health outcomes at 24-year follow-up: a prospective cohort study","volume":"77","author":"Nagata","year":"2021","journal-title":"J Am Coll Cardiol"},{"key":"2026080911292617600_zwac180-B27","doi-asserted-by":"crossref","first-page":"1094","DOI":"10.1080\/17461391.2021.1897166","article-title":"Physical activity, screen time and the COVID-19 school closures in Europe - An observational study in 10 countries","volume":"22","author":"Kovacs","year":"2022","journal-title":"Eur J Sport Sci"},{"key":"2026080911292617600_zwac180-B28","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1186\/s12889-021-12483-0","article-title":"The impact of COVID-19 on physical activity behaviour in Italian primary school children: a comparison before and during pandemic considering gender differences","volume":"22","author":"Dallolio","year":"2022","journal-title":"BMC Public Health"},{"key":"2026080911292617600_zwac180-B29","doi-asserted-by":"crossref","first-page":"11286","DOI":"10.3390\/ijerph182111286","article-title":"Impact of the COVID-19 pandemic on sedentary time and behaviour in children and adults: a systematic review and meta-analysis","volume":"18","author":"Runacres","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"2026080911292617600_zwac180-B30","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1177\/19417381211039746","article-title":"Return to activity after SARS-CoV-2 infection: cardiac clearance for children and adolescents","volume":"14","author":"Chowdhury","year":"2022","journal-title":"Sports Health"},{"key":"2026080911292617600_zwac180-B31","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1056\/NEJMoa2021680","article-title":"Multisystem inflammatory syndrome in U.S. children and adolescents","volume":"383","author":"Feldstein","year":"2020","journal-title":"N Engl J Med"},{"key":"2026080911292617600_zwac180-B32","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1093\/eurheartj\/ehaa605","article-title":"2020 ESC Guidelines on sports cardiology and exercise in patients with cardiovascular disease","volume":"42","author":"Pelliccia","year":"2021","journal-title":"Eur Heart J"},{"key":"2026080911292617600_zwac180-B33","doi-asserted-by":"crossref","first-page":"1174","DOI":"10.1136\/bjsports-2020-102637","article-title":"Infographic. Graduated return to play guidance following COVID-19 infection","volume":"54","author":"Elliott","year":"2020","journal-title":"Br J Sports Med"}],"container-title":["European Journal of Preventive Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/eurjpc\/advance-article-pdf\/doi\/10.1093\/eurjpc\/zwac180\/45690225\/zwac180.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eurjpc\/article-pdf\/29\/16\/2120\/60914192\/zwac180.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eurjpc\/article-pdf\/29\/16\/2120\/60914192\/zwac180.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,9]],"date-time":"2026-08-09T15:29:38Z","timestamp":1786289378000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eurjpc\/article\/29\/16\/2120\/6691819"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,5]]},"references-count":33,"journal-issue":{"issue":"16","published-online":{"date-parts":[[2022,9,5]]},"published-print":{"date-parts":[[2022,11,15]]}},"URL":"https:\/\/doi.org\/10.1093\/eurjpc\/zwac180","relation":{},"ISSN":["2047-4873","2047-4881"],"issn-type":[{"value":"2047-4873","type":"print"},{"value":"2047-4881","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,11,1]]},"published":{"date-parts":[[2022,9,5]]}}}